Objective: To explore the effect of positive ruminat thinking training on negative emotions, fatigue status and sleep quality of chronic kidney disease stage 5 (CKD5) hemodialysis patients. Methods: A total of 100 hemodialysis patients with CKD5 admitted to our hospital from January 2020 to June 2021 were selected and randomly divided into a control group (n=50) and an observation group (n=50). The control group received routine nursing and the observation group received positive ruminat thinking training. The Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were used to evaluate the anxiety and depression of patients before and after the intervention. The Fatigue Scale-14 (FS-14) was used to evaluate the fatigue degree of patients before and after the intervention. And the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality of patients before and after the intervention. Results: After the intervention, the SAS score and SDS score of the observation group were significantly lower than those of the control group, and the difference was statistically significant (both P<0.05). After the intervention, the total score of FS-14 scale, physical fatigue, and mental fatigue scores in the observation group were significantly lower than those in the control group (all P<0.05). After the intervention, the PSQI score of the observation group was significantly lower than that of the control group (P<0.05). Conclusion: Positive ruminat thinking training can not only alleviate the emotional state and fatigue state of hemodialysis patients with CKD5, but also help to improve their sleep quality, which is an effective intervention method to improve the physical and mental health and quality of life of patients.